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X-eHealth: eXchanging electronic Health Records in a commom framework

Periodic Reporting for period 1 - X-eHealth (X-eHealth: eXchanging electronic Health Records in a commom framework)

Reporting period: 2020-09-01 to 2021-08-31

The lack of interoperability is the most persistent barrier to the deployment of digital health services and one major factor holding back investments in digital health infrastructures. Well implemented and interoperable eHealth services used by health professionals and citizens can be a major societal contribution to improve healthcare in Europe with a high socio-economic return.

X-eHealth specific objectives are:
1. To reach a common understanding in the EU on the efforts needed to adopt the commonly defined EEHRxF specifications at different levels and within their nationIEHR solutions
2. To define, specify and demonstrate the EEHRxF use cases laboratory results, medical imaging and reports, hospital discharge reports and patient summary for those suffering from rare disease and/or comorbidities.
3. To elaborate the roadmap for the above-mentioned use cases for future uptake on the eHDSI as well as for the additional usage within MS on national, regional or local level
4. To submit the outcomes and recommendations of X-eHealth regarding EEHRxF deployment to the relevant bodies on policy, strategic and operational level (e.g. eHealth Network, National Competence Centres for eHealth, eHDSI operators)
5. To propose a governance framework for the sustainable maintenance, evolution, and distribution of standardization and interoperability
The activities here reported are focused on the core activities of the project(WP4, WP5, WP6, WP7 and WP8), the other activities are being executed as planned.

Work Package 4 - Task 4.1:
This task during this first period described the state of play of electronic identification (eID) in the eHealth domain.
Task 4.1 of the X-eHealth project will be addressing these topics in two phases:
•The document at hand, D4.1.1 is focused on the current solutions deployed among the MS and the EU-wide standards in force;
•The deliverable D4.1.2 planned for M18, will be focused on the next steps the MS could consider, taking into consideration eIDAS Regulations.

Work Package 4 - Task 4.2:
•Collaborative production of the following deliverables:
o D4.2.1 “Information paper on the current challenges in legal aspects of cross-border exchange of personal data“

Work Package 4 - Task 4.3:
o D4.3.1 “European trust space background”
o ID4.3.1 - Methodology framework recommendation (M08 - Delivered)
Submission to the EC. (External Documents only)
• The ongoing activity on task 4.3 is the production of the internal deliverables:
o ID4.3.2 and ID4.3.3

Work Package 5 - Task 5.1:
In order to produce the Definition of EEHRxF functional specifications, the following tasks were performed:
• Co-creation of deliverable ID5.1.
• Team working on a consolidated description of interoperability use cases, in order to connect with realization scenarios of WP6.
• Release of ID5.1 shared with EC for informal feedback.

Work Package 5 - Task 5.2:
• Clinical guidelines: ID 5.2 Co-production of deliverable;
• Clinical guidelines: ID 5.2 first release delivered;

Work Package 5 - Task 5.3:
• Use-cases identified, prioritized, Lab report use case described in detail
• Logical information model (Lab & Common) now internally reviewed
• Release of ID5.3 shared with EC for informal feedback.

Work Package 5 - Task 5.4:
• XDS Metadata set
• Example radiology reports (mamma ca, rectum ca)
• Imaging: ID5.4 processing input from stakeholders, restructuring the document, and set up stakeholder analysis
• Development of Information Model

Work Package 5 - Task 5.5:
• Templates finalized for Use-case description, Data Elements and Functiona/Non-functional requirements
• Work on logical model, collaboration ongoing with WP6
• Release of ID5.5 shared with EC for informal feedback.

Work Package 5 - Task 5.6:
• Introduction and Context Chapters finalized
• Co-production of content for deliverable ID5.6
• Release of ID5.6 shared with EC for informal feedback.

Work Package 6 - Task 6.1:
• Specify how to technically implement the use cases selected by WP5 by using existing standards and profiles.
• Specifying the transport mechanisms for this content relying on security requirements and other infrastructural services developed by WP4 and implemented in WP7.
• Generate the testing tools (e.g. test scripts, validation tools)

Work Package 6 - Task 6.2:
ID6.2.1 - X-eHealth Implementation Guide: Medical Imaging Domain
First release of the content technical specifications (e.g. CDA Template) for the Medical Imaging domain, expressed by using standardized computable formats and published in a human-readable format. Internal deliverable.

Work Package 6 - Task 6.3:
ID6.3 - X-eHealth Implementation Guide: Hospital Discharge Report.
–First release of the content technical specifications (e.g. CDA Template) for the Hospital Discharge Report, as mentioned in T6.2.

Work Package 6 - Task 6.4:
ID6.4 - X-eHealth Implementation Guide: Patient Summary for Rare Diseases.
First release of the content technical specifications (e.g. CDA Template) for the Patient Summary for Rare Diseases, as mentioned in T6.2.

Work Package 7 - Task 7.1:
The main activities that were performed during this period to achieve the goals planned for the T7.1:
• Started to describe and analyse use case Laboratory Request and Report (business architecture);
• Align task scope planning with eHDSI wave;
• Re-planning T7.1 timeline to provide Documents to eHDSI (see below for further detail)
Work Packages 5,6 and 7: Intermediate Deliverables from WP5, WP6 and WP7 were shared with EC for informal feedback.

Work Package 8 - Task 8.1:
• A comprehensive list of standards organisations has been produced: HL7 and its Affiliates, CEN National committees’ , IHE, Orphanet, SNOMED, EHN/eHMSEG Communities, eHDSI and WHO;
• Examples of well-established and successful CoPs have been presented in WP8 meetings;
• Deciding on meetings placeholders and effort allocation by participants, potentially separately for each respective working group;
• Co-production of D8.1 - EEHRxF Community of Practice.

Work Package 8 - Task 8.2:
• Discussion on the working methodology: collaboration for a common approach on Tasks 8.1 & 8.2 a 3-phased working methodology was suggested:
o Phase 1 (M9 - M12): Identification and access of relevant use cases, definition of goals and investigation of relevant Pre-Commercial Procurement projects.
o Phase 2 (M12 – M16): Assessment of specifications and finalization of selected Proof of Concepts.
o Phase 3 (M16 – M20): Running of POCs and finalization of deliverable
• The profile of potential partners to become engaged and consequently the contents of the questionnaire that we agreed should be developed.

Work Package 8 - Task 8.3:
Prepare perational planning.

Work Package 8 - Task 8.4:
• Discussion on how to move forward;
• The profile of potential partners to become engaged and consequently the contents of the questionnaire that we agreed should be developed;
• Preparation of Innovation day, held with different stakeholders: Care Provision, Member States, Innovators and Infrastructure;
• Production of deliverable D8.1 – EEHRxF Community of Practice. This deliverable provides guidance on the terms of reference for establishing a successful CoP.
The core features of the project (WP5, WP6 and WP7) are still under development. Expected Results from M22 to M24 of the X-eHealth project.
X-eHealth - eXchanging electronic Health Records in a common framework